Download SRSA application form

Sighthound Rescue SA
[email protected]
Application for Adoption of a Sighthound
I, _____________________________________________________, owner/tenant of
______________________________________________________
herewith apply for permission to keep the following Sighthound adopted from Sighthound Rescue SA
(SRSA) on the premises:
Colour:
Age:
Sex:
I hereby agree to keep my pet in a responsible manner and to provide proper care as set out in the
adoption policy.
All animals adopted from the HWC Rescue Scheme will be sterilised if age-appropriate, microchipped,
inoculated, dewormed and a property check will be conducted by a representative of the HWC.
____________________________
_________________
Signature
Date
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Personal details of applicant
Full name: ______________________________________________________________
Home address: __________________________________________________________
Postal address: __________________________________________________________
Telephone numbers:
Home: ________________________
Work: _______________________
Cell (1): _______________________
Cell (2): _____________________
Email: ________________________
ID: _________________________
Occupation: ____________________
Work address: ________________
Your family
How many adults in the family? _________________________________________________
How many children and ages? __________________________________________________
Is there someone at home during the day? _________________________________________
Specify: ____________________________________________________________________
Your pets past and present
How many dogs/cats have you owned over the past five years?
Dogs: __________________
Cats: ___________________
What happened to the pets you no longer have? ___________________________________
Details of dogs/cats you currently own:
Breed
Age
Sex
Sterilised?
Yes/No
Dewormed?
How often?
Inoculated?
How often?
Other pets:
Do you think your current pets will adjust to a the dog you are applying for?
___________________________________________________________________________
What brand of food do you feed your animals? ______________________________________
Have you ever sent a dog to a shelter or given a dog away? ____________________________
Have you ever had a pet euthanised? _____________________________________________
If yes, please explain: __________________________________________________________
Have you ever adopted an animal before?____________
When?__________________
Why do you want a dog:

Companion for other dog?

Hunting/racing?

Companionship?

Personal protection?

House pet?

Breeding? HWC does not allow

Watchdog?

Other specify: _________________________________________________________
Whippets to be adopted for breeding.
What made you decide on a Whippet as your choice for a pet dog?
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___________________________________________________________________________
Is the Sighthound for yourself? ___________
Can you afford private veterinary fees? ____________
Details of your vet: ____________________________________________________________
Will you exercise your dog regularly?______________________________________________
Will you walk the Whippet walk on a lead?_________________________________________
Where will the dogs be kept during the day? Indoors / Outdoors
If outdoors during the day, what kind of shelter will you provide?

Kennels?


Garage?

Other specify: ________________________________________________________
Verandah?
Where will the dogs be kept at night? Indoors mandatory – not negotiable
Who will look after your dogs when you go away on holiday?___________________________
If you move, will you take the dogs with you?________________________________________
If no, please explain: ___________________________________________________________
Will you allow a representative to do a home check? __________________________________
Will you take responsibility for the dog for the next 10 to 16 years? ______________________
What provisions will you make for the dog should you become unable to care for it?
_____________________________________________________________________________
Your property
Do you rent or own your residence?_________________________________________________
Type of dwelling?

House

Flat

Cluster

Townhouse

Cottage

Plot

Other specify: ___________________________________________________________
How long have you stayed there?___________________________________________________
Full description of your fencing and gates (height and type):
_____________________________________________________________________________
Is your yard open plan or divided? ___________________________________
Do you have an area which is secure from gates opening to the road for when your dog is outside?
______________________________________________________________________________
Do you have a swimming pool? _____________________________________________________
If so, is it enclosed or otherwise made safe? __________________________________________
Declaration
I, the undersigned, hereby declare that the above information is correct and agree to pay the full
adoption fee of R__________ to Sighthound Rescue SA.
_____________________________
______________________
Signature
Date
_____________________________
3
Witness for SRSA
Sighthound Rescue SA Adoption Policy
Please read this adoption policy carefully as it is an agreement between SRSA and the undersigned.
1. I declare that I am over the age of 18 years.
2. I will not chain/cage the animal and I understand that if it is found chained/caged, it will be
removed from my care immediately.
3. I take note that it is against SRSA policy to dispose of an animal adopted from the SRSA Rescue
Scheme by selling it or giving it away as a gift to a third party. If for any reason I am unable to
keep the Sighthound, I will return it the the SRSA.
4. I will ensure that all inoculations and deworming are kept up to date, that rabies vaccinations are
done every three years and, in case of injury or illness, I will provide qualified veterinary care.
5. After adoption, the costs of inoculations and deworming, as well as any other veterinary costs,
become my responsibility.
6. I will notify SRSA immediately should the Sighthound die (in writing and the reason) or go missing.
7. I will not use or allow the Sighthound to be used for hunting or racing.
8. I will notify SRSA of any change of address and contact details.
9. I consent to the compulsory sterilisation of the Sighthound by the SRSA if age-appropriate. If the
Sighthound is less than six months old, I agree to sterilise this Sighthound at six months of age
and to supply veterinarian confirmation of this procedure to SRSA.
10. I will ensure that my Sighthound is properly and adequately fed and housed.
11. I will make proper boarding arrangements for the Sighthound when I go on holiday.
12. I will permit a rperesentative of the SRSA to visit my premises to perform checks on the
Sighthound and the conditions in which it is kept.
13. I will allow SRSA to repossess the Sighthound without any refund if, in the opinion of SRSA, the
terms of this agreement have not been adhered to in spirit and deed.
14. My property is adequately enclosed and at no time shall I knowingly allow my Sighthound to roam
the streets.
15. I reserve the right to discuss the content of this agreement with an authorised member of SRSA
should there be any unclarity.
16. I hereby declare that I accept and understand the adoption policy.
_________________________________
Name and surname
_____________________________
Signature
__________________________________
SRSA witness
____________________________
Date
Sighthound
Sex: _____________________________
Age: ________________________
Colour: ___________________________
Microchip: ____________________
Please do not hesitate to phone your contact person SRSA for advice. Any communication from you
regarding the progress of your puppy is always greatly appreciated.
Special Sighthound collars and pyjama coats, which are required in winter, are available from
Rosemary Smith on 016-366-4078 or [email protected].
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